My Emergency Room Horror Story

[tavalon]

85. I'm not saying that doesn't happen

I am saying there is a huge gray market out there that you fine folks seem to be oblivious to. When my friend with Psoriatic arthritis and a sed rate through the roof, was called a drug seeker, she just turned to the overseas gray market. She needs pain meds to be able to get out of bed. She also needs (this, from me, her friend, the nurse) to get her ass to a decent rheumatologist, get on Embrel and hopefully, won't need those meds anymore.

This may well be a class issue, I don't know. But I do know that she isn't alone. And that many, many people with legitimate pain issues are being under treated for what ever reasons there might be. And middle class people don't hit the street, they hit the internet.

BTW, as an aside, I have IBS and when I get a really bad attack (like after a noro virus), the only thing that works is Lorazepam and it works fast. 2 days in most cases. To avoid being called a drug seeker, I put the rest of the lorazepam in a safe place (an actual safe for drugs, they actually have such things) for when I next need it. Luckily, there is much I can do to avoid an IBS attack and do, on a daily basis. Amytriptyline is the greatest thing ever for my IBS, as is exercise, avoiding certain foods (having Celiac as well, it's amazing there is actually food I can eat. LOL), avoiding ALL alcohol and using bulking fiber whether it's IBS-D or IBS-C. Did I mention probiotics? My doctor rocks. She understands IBS and I've told her my whole regimen and she is copacetic. She also almost always has another idea or two I hadn't thought of. And, since I have a trusting relationship with her, I almost always try her ideas unless they are forgetfully cornball, like, eat wheat bread! She caught herself really quickly.

Now, I know we are talking narcotics rather than sedatives, but they aren't so far apart, are they, really? Of course, if I needed sedatives all the time, I would be working with my doctor to come up with other things. But that's me. I have an immune system that's been trying to take me out since I was two years old. I'm now 50. My medical records could easily point to drug seeking, and yet, it's not true.

As a second, BTW, until I found my current physician, I always preferred PA's and NP's. They often have a listening and caring gene lacking in physicians. I know that you see "drug seeking" a lot but there is much you do not see. I think the under treatment of pain is a fair greater issue. When my friend finally gets onto Embrel and assuming (hoping) it makes her better, I will be there to help her safely taper off of the pain meds she's on. Unless she gets a good rheumatologist, then I will definitely leave that to her/him.

It's funny, my friend is terrified of addiction and yet, she doesn't realize that she has been taking the pain med for so long, she can't stop cold turkey. She doesn't show any of the usual signs of addiction, but she now has a high tolerance. Without a caring medical professional around (right now, that seems to be me. I don't know how she picks assholes as doctors on a regular basis, but that's a whole other story). Her psychiatrist rocks and BTW, is the only one who sussed out how she is getting the pain medicine she is using - this doctor is the only one who looks at her situation holistically. Needless, to say, her psychiatrist can't or shouldn't prescribe them, but knowing about her arthritis, she understands the problem and is monitoring it - her psychiatrist!

Sorry such a long post but under treatment of chronic pain is kind of a hot button with me.

Oh, and to fill out the picture of how I know the difference between addiction and tolerance, I volunteer with a group that offers clean needles, Hep B shots and education on overdose and the use of Narcan. Trust me, you never see those people in your clinic. Then again, maybe with ACA, that will change, but I doubt it.

We are both on the front lines but very different front lines, I'd say.

None of this is meant as a diss on you - I'm guessing you are a great PA. You just gave me a great post to pull my soapbox up to.